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“it seems to differ from the official ferric citrate so far as essentials go only in color, but custom, which is exceedingly hard to change in south america, demands that this green variety of ampules be used in place of the official product ”in reply to a similar letter of inquiry e r squibb and sons wrote. “iron citrate green iron and ammonium citrate green differs from the u s p iron and ammonium citrate in that it contains less iron and more citric acid and more ammonium citrate than does the latter it is of course a modification of the official salt and is supplied to meet a real demand its reaction is quite decidedly acid and our present stock contains fe slightly below the u s p requirements for iron, assaying 15 74 per cent instead of 16 per cent fe the tests used to control its quality are those for the official product except as before indicated, it is always acid instead of neutral, as the u s p requires for that salt ”the smaller iron content 98 per cent of the u s p requirementof the green variety referred to by e r squibb and sons is so smallas to be negligible further, the low iron content as well as theacidity of the green salt would appear to be detriments rather thanadvantages inasmuch as no evidence has been presented to show thatiron citrate green is superior in any way to the well-known iron andammonium citrate the council held that iron citrate green, and with itthe dosage forms, was ineligible to n n r the preceding report was submitted to the mulford company and to e r squibb and sons for comment before publication the former firm repliedthat in the present case it felt bound to supply the existing demand, the latter replied that, to give the council its support in thismatter, the sale of iron citrate green and ampules thereof would bediscontinued -- from the journal a m a , jan 13, 1917 aspirin report of the council on pharmacy and chemistrythe referee report on aspirin-bayer which follows was submitted tothe council and adopted by it and, in accordance with the refereerecommendation, was sent to the bayer company, inc the company replycontained nothing to warrant the continued recognition of this productby the council it was accordingly directed that aspirin-bayer beomitted from new and nonofficial remedies w a puckner, secretary referee reportthe referee attention has been called to the systematic campaignof advertising aspirin to the public he is informed that tabletshave been marketed for essay time in “vest-pocket” boxes, bearing thename “aspirin” permanently affixed, which is in technical conflictwith the council rule against indirect advertising to the public more recently, conspicuous advertisements have appeared in dailypapers these are technically in conflict with the rule against directadvertising to the public in addition to the plain technical conflicts with the council rulesthere is a feature of the case which has not hitherto been raisedand which should be fully considered. It may be remarked that theadvertisements contain no therapeutic recommendation, and do not, ontheir face, urge the public to employ aspirin but apparently merelytell the public how it may protect itself against sophistication in substance, they say. “if you are a user of aspirin, this is howyou may obtain the genuine ” it might be said that this is not anattempt to increase the use or sale of aspirin-- the ordinary object ofadvertising-- but that the means of protection against adulteration isa “subject on which the public should be instructed ” the principleof such exceptions is stated in the comments to rule 3 new andnonofficial remedies, 1916, p 15.

2 that secretin given by the mouth is absorbed and producesincreased secretion of the pancreatic and intestinal juices and of thebile from an examination of the evidence available, including thatsubmitted by the manufacturers, the council concluded. “1 no evidencehas been presented that the absence of secretin is a cause ofgastro-intestinal disease 2 there is no evidence that secretin inany form is physiologically active when administered by mouth ” thatthese conclusions were justified is shown again by the review givenby carlson of the literature, much of which was also reviewed in thecouncil previous report since the claims of the carnrick company were not supported by anysatisfactory evidence, no further investigation on the council writingwas necessary to warrant rejection of the product the council didnot undertake to determine, for instance, whether or not secretogenand similar products actually contain secretin. The determination ofthis point was immaterial here, in view of the conclusiveness of theevidence that secretin given by mouth has no physiologic action since firms other than the g w carnrick company are manufacturingalleged secretin preparations, and since recommendations for the useof secretin preparations in gastro-intestinal diseases have even creptinto textbooks, it seemed desirable to obtain further information oncertain points the council therefore requested prof a j carlsonof the university of chicago to check the results of previousinvestigators with regard to the action of secretin administered bymouth or directly into the intestine, and, in addition, to investigatethe secretin content of certain alleged secretin preparations carlson and his co-workers, like all previous investigators, found thatsecretin given by mouth, or introduced even in enormous doses directlyinto the intestine, is entirely inactive they also found that markeddestruction of secretin followed contact for one minute with humangastric juice and that secretin is rapidly oxidized and rendered inertin contact with the air further, they were unable to demonstrate the presence of secretinin samples of secretogen and another supposed secretin preparation duodenin bought on the open market in the case of secretogen therewas one exception. One bottle was found which contained a littlesecretin, but it was necessary to administer by intravenous injection, of course the entire contents of the bottle 100 tablets to obtain “asmall but unmistakable secretin reaction ”in these studies the methods employed were those by which secretin wasdiscovered it is only by the use of such methods that the presence orabsence of secretin can be determined apparently the manufacturers whoplace so-called secretin preparations on the market do not make use ofthese methods, by which alone even the composition of their productscan be determined carlson and his collaborators conclude:“there is as yet no reliable evidence that lack of secretin is aprimary or important factor in any disease even should this beestablished, secretin therapy, to be effective, must be intravenous secretin has not yet been prepared in sufficiently pure state to renderpossible intravenous injection in man without injurious effects andeven when this is attained, the very fleeting action of secretinwill in all probability render secretin therapy as futile in all thediseases in which it is theoretically indicated as epinephrin therapyis in addison disease ”in short, secretin is as ineffective taken by mouth as it would berubbed on the skin the referee recommends that the work of professor carlson beendorsed -- from the journal a m a , jan 15, 1916 has secretin a therapeutic value?. B a j carlson, ph d , j e lebensohn, m s , and s j pearlman, b s chicagob from the hull physiological laboratory of the university of chicago b this investigation was undertaken at the request of the council onpharmacy and chemistry the following report, having been submittedto the council, received its endorsement see preceding report of thecouncil on pharmacy and chemistry, “so-called secretin preparations” it is well established that acid chyme in the duodenum is the normalstimulus to the secretion of pancreatic juice 31 interaction ofthe acid with the duodenal mucosa liberates into the blood stream asubstance which, circulating through the pancreas, excites the latterto activity this exciting substance has been termed “secretin ” itcan be prepared artificially by macerating duodenojejunal mucosa in0 4 per cent hydrochloric acid, neutralizing the boiling mixture, andfiltering a few cubic centimeters of the filtrate injected into avein produce invariably a powerful secretion of pancreatic juice 32that a “chemical messenger” is at the basis of the duodenal acidreflex has been proved by even more crucial experiments-- transfusion wertheimer, 33 enriquez and hallion34, cross circulation fleig, 35 matuso36, and perfusion of the isolated pancreas huston37 31 pawlow.

Also duotonol tablets, said to contain equalwritings of calcium and sodium glycerophosphates. Triotonol tablets, each said to contain “sodium tonol 2-1/2 grains, lime-tonol 2-1/2grains, strychnine-tonol 1/60 grain”. Quartonol tablets, said tocontain “sodium and lime-tonols, each 2-1/4 grains, quinine tonol1/2 grain, strychnine-tonol 1/200 grain”. Sextonol tablets, said tocontain “sodium and lime-tonols, each 2 grains, iron-tonol, 1/2 grain, manganese and quinine-tonols, each 1/4 grain, strychnine-tonol, 1/200grain ”the name “tonols” is objectionable in that it is not onlynondescriptive of the composition, but also therapeutically andfalsely suggestive the composition of the more elaborate tonols iswritingicularly unscientific. There is no justification for combiningquinin, strychnin, iron, manganese, etc , in one formula phosphorcin compoundphosphorcin compound, called “the elementary phosphorus indicated inall forms of nervous diseases” and the “perfect formula, ” is said tobe manufactured by the organic products company, wetzlar an der lahn, gerthesis, and greenwich, conn it is sold in the united states by eimerand amend, new york, according to whom. “each two fluidrachms contain. “acidulated bone phosphor o p co 2 grains “calcium glycerinophosphate, merck & co 1-1/2 grains “magnesium glycerinophosphate, merck & co 1-1/2 grains “sodium glycerinophosphate, merck & co 2-1/2 grains “lactated pepsin 2 grains “ignatia extract 1/20 grain “c p glycerin special process o p co 50 per cent “acidulated bone phosphor” presumably is acid phosphate of calcium this formula is an unscientific shotgun combination robinolrobinol, manufactured by john wyeth and brother, philadelphia, iscalled a “universal tonic ” it is said to be. “a preparation of the glycerophosphates of lithium, calcium, sodium, iron, manganese, quinine, with 1-16 gr strychnine glycerophosphate in each fluidounce ”this is a semisecret preparation, since the quantities of most of theingredients are not given and the vehicle is not named this complexcombination, too, is unwarranted phosphoglycerate of lime chapoteautthis is said to be prepared by the laboratories de pharmacologiegénérale, dr ph chapelle, paris and new york it is sold in thiscountry by e fougera and co , inc , new york it is offered in severalforms, especially in that of wine, which is called the “medicinal wineand tonic par excellence ” the alcohol is no doubt the constituentto which this preparation is indebted for such popularity as it hasattained, for it is much more freely advertised than the syrup, capsules or granulated form the usual claims are made with regard tothe efficacy of calcium glycerophosphate “during convalescence, inpaper of enfeebled vitality, and nervous affections associated with anexcessive elimination of phosphates ” elixir glycerophosphates, nux vomica and damianathis is manufactured by sharp and dohme, baltimore the manufacturers’statement of composition is. “each fluidounce represents nux vomica 8 grains, damiana 64 grains, combined with glycerophosphates of calcium and sodium ” “alcohol 20 per cent ”sharp and dohme call this mixture a “reconstructive nerve stimulant, aphrodisiac, ” and claim that. “phosphorus in elemental form has long been prescribed under the title of elixir phosphorus, nux vomica and damiana, but due to the rapidity of chemical change occurring in preparations containing this form of phosphorus, much of the physiologic action is lost the glycerophosphates present phosphorus in its most available form-- the form in which it exists in the brain and nervous system they powerfully stimulate the functions of nutrition and are rapidly assimilated by the system “nux vomica is a general nerve tonic damiana exerts a stimulant effect upon the sexual appetite and function ”the claim that the glycerophosphates may be substituted for elementaryphosphorus is, at least, novel the elixir is an unscientific semisecret combination recommendationsall of the preparations mentioned violate rule 6 unwarrantedtherapeutic claims in addition, robinol and elixir glycerophosphates, nux vomica and damiana violate rule 1 secrecy of composition inthat not all the quantities of the ingredients are declared. Tonols, phosphorcin compound and robinol violate rule 8 objectionable names it is recommended that the council endorse marshall findings98 anddeclare that tonols schering and glatz, phosphorcin compound eimerand amend, robinol john wyeth and brother, phosphoglycerate oflime chapoteaut e fougera and co , and elixir glycerophosphates, nux vomica and damiana sharp and dohme are ineligible for new andnonofficial remedies -- from the journal a m a , sept 30, 1916 hydras report of the council on pharmacy and chemistryhydras, sold by john wyeth and brother, philadelphia, is one of thethesis proprietary, so-called “uterine tonics ” it is said to contain“cramp bark, helonias root, hydrastis, scutellaria, dogwood andaromatics, ” but as the amounts of the several ingredients are notgiven the statement regarding its composition is valueless the labeldeclares the presence of 24 per cent alcohol the name “hydras, ” taken in connection with the statement ofcomposition, would suggest that hydrastis golden-seal is an importantconstituent the report of the chemical laboratory of the americanmedical association, however, indicates that hydrastis is present inunimportant amounts:“the hydrastin content of hydras was determined by extraction withimmiscible solvents pharm review, may, 1908, p 132 twenty-fivec c was found to yield an alkaloid residue of 0 0160 gm thepreparation contains, therefore, not more than 0 064 gm ‘hydrastin’per 100 c c inasmuch as hydrastis is required to contain about 2 5per cent ‘hydrastin, ’ hydras contains an equivalent of not more than2 56 gm hydrastis golden seal in 100 c c and the stated dose ofhydras-- one dessertspoonful 8 c c -- represents not more than 0 2 gm or 1/10 of the u s p average dose of hydrastis ”the label of a recently purchased bottle of hydras bears the followingrecommendations for its use. “indicated in treatment of dysmenorrhea, menorrhagia anti-abortive, with anodyne and tonic properties ” “for dysmenorrhea, suppressed menses, etc , a dessertspoonful three times daily, before or after meals ” “to relieve pain due to uterine disorders, a dessertspoonful every three hours, or increased to a tablespoonful, at the discretion of the attending physician ”a circular wrapped around the bottle declares that hydras is. “a valuable preparation to the physician in the treatment of dysmenorrhea, colic, cramps, spasm, palpitation incident to pregnancy, and the various pains resulting from diseases of the female sexual organs ”it is further claimed that.

Against drugs that may and do work positiveharm. Against the veil of mystery that makes these abuses possible the individual layman cannot protect himself against these dangers, and has a right to expect that the government will prohibit theindiscriminate sale of any medicine that may be harmful to him he hasa right to expect, when the government permits the sale of a patentmedicine, that the medicine will do him no harm. Just as he has a rightto expect that any physician whom the government permits to practice, should be competent these are essay of the reasons why physicians oppose patent medicinesas they are now exploited. And for these reasons, physicians shouldtake an absolutely uncompromising attitude, and use every opportunityto educate the public the patent medicine interests naturally tryto obscure the issue by the art in which they are so skilful, theyaim to suggest to the public that physicians are opposed to patentmedicines, in order to drive patients to their offices they “forget”to mention that physicians have never conducted a “campaign” againstreally efficient preventive public-health measures, no matter how thesisprospective patients were involved no physician has ever refused togive diphtheria antitoxin because this would diminish the number of hisvisits a short memory is a very convenient asset for self-interestedpersons it is not so convenient for the public-- but it is all toofrequent physicians must, therefore, make it plain that their stand isnot against patent medicines, but for the protection of the health ofthe public -- from the journal a m a , march 4, 1916 drug therapy. The fallibility of textbooksuntil very recently, we were compelled to acknowledge that little, if any, progress was being made in internal medicine so far as drugtherapy was concerned everybody knows of the progress made in otherbranches-- in bacteriology, in pathology, in biologic chemistry, in surgery, in etiology and in application of technical methodsto diagnosis recently, however, pharmacologic research and theapplication of scientific methods in the study of the physiologicaction of drugs are resulting in definite, positive progress animportant lesson, incidentally learned through this scientificinvestigation, is the fallibility of the drug therapy described intextbooks the explanation is, of course, that thesis of these textbooksare mere compilations containing false statements, unproved theories, and unverified clinical evidence representing the guesswork of ancientuncritical observers thesis drugs have been, and still are, vaunted intextbooks as valuable in a variety of conditions, whereas scientificinvestigation and controlled clinical observation have proved them tobe totally worthless. Others are proving to be of value in an extremelylimited number of conditions the sooner writers of textbooks realizethis fact and enter into the spirit of the new era, the better forthe public and for scientific medicine -- editorial from the journala m a , may 27, 1916 thomas webster edgar tired rabbits for diabetes. Ring-tailed monkeys for sex stimulationduring the last two or three years the journal has received inquiriesregarding one thomas webster edgar, m d , of new york city, first, relative to his alleged treatment for diabetes and more recently abouthis “monkey gland” treatment for sex stimulation here is one from aphysician in washington.

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I knew those various affectionsin man, in respect of sickness and health, were caused naturally though god may have other ends best known to himself by the variousoperations of the microcosm. And i could not be ignorant, that as thecause is, so must the cure be. And therefore he that would know thereason of the operation of the herbs, must look up as high as thestars, astrologically i always found the disease vary according to thevarious motions of the stars. And this is enough, one would think, toteach a man by the effect where the cause lies then to find out thereason of the operation of herbs, plants, &c , by the stars went i. Andherein i could find but few authors, but those as full of nonsense andcontradiction as an egg is full of meat this not being pleasing, andless profitable to me, i consulted with my two brothers, dr reason anddr experience, and took a voyage to visit my mother nature, by whoseadvice, together with the help of dr diligence, i at last obtained mydesire. And, being warned by mr honesty, a stranger in our days, topublish it to the world, i have done it but you will say, what need i have written on this subject, seeing sothesis famous and learned men have written so much of it in the englishtongue, much more than i have done?. To this i answer, neither gerrard nor parkinson, or any that ever wrotein the like nature, ever gave one wise reason for what they wrote, andso did nothing else but train up young novices in physic in the schoolof tradition, and teach them just as a parrot is taught to speak. Anauthor says so, therefore it is true. And if all that authors say betrue, why do they contradict one another?.